The Wicked Doctor

38: Sickle Cell Disease (Revised)

Sickle cell disease is a group of disorders that affects , the molecule in red blood cells that delivers oxygen to cells throughout the body. People with this disorder have atypical hemoglobin molecules called hemoglobin S, which can distort red blood cells into a , or crescent, shape.

Signs and symptoms of sickle cell disease usually begin in early childhood. Characteristic features of this disorder include a low number of red blood cells (), repeated infections, and periodic episodes of pain. The severity of symptoms varies from person to person. Some people have mild symptoms, while others are frequently hospitalized for more serious complications.

The signs and symptoms of sickle cell disease are caused by the sickling of red blood cells. When red blood cells sickle, they break down prematurely, which can lead to anemia. Anemia can cause shortness of breath, fatigue, and delayed growth and development in children. The rapid breakdown of red blood cells may also cause yellowing of the eyes and skin, which are signs of jaundice. Painful episodes can occur when sickled red blood cells, which are stiff and inflexible, get . These episodes deprive tissues and organs of oxygen-rich blood and can lead to organ damage, especially in the lungs, kidneys, spleen, and brain. A particularly serious complication of sickle cell disease is high blood pressure in the blood vessels that supply the lungs (pulmonary hypertension). Pulmonary hypertension occurs in about one-third of adults with sickle cell disease and can lead to heart failure.

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"You're anemic. Your hemoglobin is only 6.7 g/dL and your ferritin level is just 16 mmol/L. I'll give you a daily infusion of iron dextran for 5 days and then after than you would have to take iron supplements."

Napabuntong hininga na lang ako. Unang araw ko at andaming nangyayari. I got sick and I fainted.

The biggest scoop of the day was... Finding out that the man I was supposed to marry was already married to someone else.

How the fuck did that happen? Nawala lang ako ng anim na buwan pagbalik ko nagpakasal na sa ibang babae ang fiancee ko? Anong kagaguhan ito?

Gustong gusto ko nang sugurin si Terrence para sampalin at maconfirm sa mismong bibig niya ang katotohanan pero kinailangan kong pigilin ang sarili ko. I still have my pride and I don't want to look like a sore loser who can't accept her defeat.

Hindi naman ako tanga. I studied for more than 8 years para maging doktor. All the evidence point to one conclusion and I am not stupid not to believe if the body of proof presented in front of me. The only thing I wanted was verbal confirmation from the man himself. I wanted to hear his explanation. I wanted to hear directly from his mouth how the hell this happened and why the fuck does he keep on lying to me.

Relax. Breathe in, breathe out. First day at work and this happens.

Are you fucking kidding me???

How fucking lucky can I be???

Tumayo na ako at lumabas ng kwarto na nakasukbit ang white coat ko sa kaliwa kong braso. With calculated steps, I walked towards the doctors lounge to grab a packet of orange juice from the mini refrigerator. Kailangan ko ng energy sa trabaho. Hindi na ako nakapag-almusal bago ako umalis ng bahay dahil wala na akong ganang kumain matapos ang nangyari kahapon. I skipped dinner and breakfast so now I was hungry as hell but whenever I see the plate, nawawala ang appetite ko.

It's 9 am and it's time for rounds but I feel like I am floating, maybe because of hunger and stress. Contrary to my expectation, nakatulog ako kaagad kagabi nang makauwi ako. Inubos ko ang orange juice at tinungo ang internal medicine wing. I arrived at the nurses's station at a perfect timing, just a few minutes before the attending physicians came to browse the charts. Hinilot ko ang sentido ko dahil nagsisimula na itong sumakit, isama na rin ang sikmura kong mahapdi dahil wala pang kinakain simula kagabi.